Intravenous Fluid in Labor and Delivery and Postpartum Hemorrhage and Blood Transfusion: A Retrospective Study [ID 2069]

INTRODUCTION: The objective of this study was to identify a possible link between intrapartum intravenous fluid administration and risk of postpartum hemorrhage (PPH) and blood transfusion. METHODS: We performed a cross-sectional retrospective cohort analysis of hospitalizations from 2020 to 2022 resulting in spontaneous vaginal delivery (SVD) after admission for spontaneous labor in patients aged 18–55 years determined to have a low risk of PPH. Logistic regression was used to identify predictors of PPH. RESULTS: Of 4,124 hospitalizations for spontaneous labor resulting in SVD, 93 (2.3%) were complicated by PPH. The total intravenous fluid volume administered was significantly associated with the likelihood of PPH (odds ratio [OR] 1.0330; 95% CI, 1.0210, 1.0460) and transfusion of blood products (OR 1.04; 95% CI, 1.02, 1.05) when controlling for age, gestational age, anemia on admission, use of epidural anesthesia, smoking, COVID-19 infection, thrombocytopenia, length of labor, laceration, and use of tranexamic acid. Use of epidural in labor was associated with lower likelihood of PPH (OR 0.57; 95% CI, 0.37, 0.88) and blood product transfusion (OR 0.456; 95% CI, 0.26, 0.80) after controlling for the same confounding factors. CONCLUSIONS/IMPLICATIONS: Intravenous fluids during labor are associated with increased risk of PPH and blood transfusion in patients without any other identified risk factors. The ideal amount of intravenous fluid in labor is currently unknown, and future prospective studies may help guide future clinical practice.